Slow Progress in Changing the School Food Environment: Nationally Representative Results from Public and Private Elementary Schools

Background: Children spend much of their day in school, and authorities have called for improvements in the school food environment. However, it is not known whether changes have occurred since the federal wellness policy mandate took effect in 2006-2007. Objective: We examined whether the school food environment in public and private elementary schools changed over time and examined variations by school type and geographic division. Design and participants: Survey data were gathered from respondents at nationally representative samples of elementary schools during the 2006-2007 and 2009-2010 school years (respectively, 578 and 680 public schools, and 259 and 313 private schools). Main outcome measures: Topics assessed included competitive foods, school meals, and other food-related practices (eg, school gardens and nutrition education). A 16-item food environment summary score was computed, with possible scores ranging from 0 (least healthy) to 100 (healthiest). Analyses: Multivariate regression models were used to examine changes over time in the total school food environment score and component items, and variations by US census division. Results: Many practices improved, such as participation in school gardens or farm-to-school programs, and availability of whole grains and only lower-fat milks in lunches. Although the school food environment score increased significantly, the magnitude of change was small; as of 2009-2010 the average score was 53.5 for public schools (vs 50.1 in 2006-2007) and 42.2 for private schools (vs 37.2 in 2006-2007). Scores were higher in public schools than in private schools (P<0.001), but did not differ by race/ethnicity or school size. For public schools, scores were higher in the Pacific and West South Central divisions compared with the national average. Conclusions: Changes in the school food environment have been minimal, with much room remaining for improvement. Additional policy changes may be needed to speed the pace of improvement.